Provider Demographics
NPI:1821814138
Name:OFORI, EMMANUEL SARFO
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:SARFO
Last Name:OFORI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 VERNON STREET
Mailing Address - Street 2:APT 1
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01607
Mailing Address - Country:US
Mailing Address - Phone:774-578-4119
Mailing Address - Fax:
Practice Address - Street 1:193 VERNON STREET
Practice Address - Street 2:APT 1
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01607
Practice Address - Country:US
Practice Address - Phone:774-578-4119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician